Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
Identifieur interne : 001951 ( Main/Exploration ); précédent : 001950; suivant : 001952Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
Auteurs : Jeanny Kwon [Corée du Sud] ; Keun-Yong Eom [Corée du Sud] ; In Ah Kim [Corée du Sud] ; Jae-Sung Kim [Corée du Sud] ; Young-Beom Kim [Corée du Sud] ; Jae Hong No [Corée du Sud] ; Kidong Kim [Corée du Sud]Source :
- Cancer Research and Treatment : Official Journal of Korean Cancer Association [ 1598-2998 ] ; 2015.
Abstract
The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in high-risk cervical cancer treated with radical surgery and adjuvant treatment.
Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months.
The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFSwas observed in patients with perineural invasion, ≥ 2 LN metastases, LNR ≥ 10%, upper LN metastasis, and ≥ –1.05 LODDs. In multivariate analysis, ≥ –1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ≥ –1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006).
LODDs ≥ –1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ≥ –1.05, intensified chemotherapy might be required, considering the high rate of DF.
Url:
DOI: 10.4143/crt.2015.085
PubMed: 26194370
PubMed Central: 4843724
Affiliations:
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Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, In Ah" sort="Kim, In Ah" uniqKey="Kim I" first="In Ah" last="Kim">In Ah Kim</name><affiliation wicri:level="1"><nlm:aff id="af2-crt-2015-085">Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Jae Sung" sort="Kim, Jae Sung" uniqKey="Kim J" first="Jae-Sung" last="Kim">Jae-Sung Kim</name><affiliation wicri:level="1"><nlm:aff id="af2-crt-2015-085">Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Young Beom" sort="Kim, Young Beom" uniqKey="Kim Y" first="Young-Beom" last="Kim">Young-Beom Kim</name><affiliation wicri:level="1"><nlm:aff id="af3-crt-2015-085">Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="No, Jae Hong" sort="No, Jae Hong" uniqKey="No J" first="Jae Hong" last="No">Jae Hong No</name><affiliation wicri:level="1"><nlm:aff id="af3-crt-2015-085">Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Kidong" sort="Kim, Kidong" uniqKey="Kim K" first="Kidong" last="Kim">Kidong Kim</name><affiliation wicri:level="1"><nlm:aff id="af3-crt-2015-085">Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26194370</idno><idno type="pmc">4843724</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843724</idno><idno type="RBID">PMC:4843724</idno><idno type="doi">10.4143/crt.2015.085</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000729</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000729</idno><idno type="wicri:Area/Pmc/Curation">000729</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000729</idno><idno type="wicri:Area/Pmc/Checkpoint">000F49</idno><idno type="wicri:explorRef" wicri:stream="Pmc" 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Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Eom, Keun Yong" sort="Eom, Keun Yong" uniqKey="Eom K" first="Keun-Yong" last="Eom">Keun-Yong Eom</name><affiliation wicri:level="1"><nlm:aff id="af2-crt-2015-085">Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, In Ah" sort="Kim, In Ah" uniqKey="Kim I" first="In Ah" last="Kim">In Ah Kim</name><affiliation wicri:level="1"><nlm:aff id="af2-crt-2015-085">Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Jae Sung" sort="Kim, Jae Sung" uniqKey="Kim J" first="Jae-Sung" last="Kim">Jae-Sung Kim</name><affiliation wicri:level="1"><nlm:aff id="af2-crt-2015-085">Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Young Beom" sort="Kim, Young Beom" uniqKey="Kim Y" first="Young-Beom" last="Kim">Young-Beom Kim</name><affiliation wicri:level="1"><nlm:aff id="af3-crt-2015-085">Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="No, Jae Hong" sort="No, Jae Hong" uniqKey="No J" first="Jae Hong" last="No">Jae Hong No</name><affiliation wicri:level="1"><nlm:aff id="af3-crt-2015-085">Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Kidong" sort="Kim, Kidong" uniqKey="Kim K" first="Kidong" last="Kim">Kidong Kim</name><affiliation wicri:level="1"><nlm:aff id="af3-crt-2015-085">Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Cancer Research and Treatment : Official Journal of Korean Cancer Association</title><idno type="ISSN">1598-2998</idno><idno type="eISSN">2005-9256</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in high-risk cervical cancer treated with radical surgery and adjuvant treatment.</p></sec><sec><title>Materials and Methods</title><p>Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months.</p></sec><sec><title>Results</title><p>The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFSwas observed in patients with perineural invasion, ≥ 2 LN metastases, LNR ≥ 10%, upper LN metastasis, and ≥ –1.05 LODDs. In multivariate analysis, ≥ –1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ≥ –1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006).</p></sec><sec><title>Conclusion</title><p>LODDs ≥ –1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ≥ –1.05, intensified chemotherapy might be required, considering the high rate of DF.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Rotman, M" uniqKey="Rotman M">M Rotman</name></author><author><name sortKey="Sedlis, A" uniqKey="Sedlis A">A Sedlis</name></author><author><name sortKey="Piedmonte, Mr" uniqKey="Piedmonte M">MR Piedmonte</name></author><author><name sortKey="Bundy, B" uniqKey="Bundy B">B Bundy</name></author><author><name sortKey="Lentz, Ss" uniqKey="Lentz S">SS Lentz</name></author><author><name sortKey="Muderspach, Li" uniqKey="Muderspach L">LI Muderspach</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Song, S" uniqKey="Song S">S Song</name></author><author><name sortKey="Song, C" uniqKey="Song C">C Song</name></author><author><name sortKey="Kim, Hj" uniqKey="Kim H">HJ Kim</name></author><author><name sortKey="Wu, Hg" uniqKey="Wu H">HG 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sortKey="Montana, G" uniqKey="Montana G">G Montana</name></author><author><name sortKey="Creasman, Wt" uniqKey="Creasman W">WT Creasman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Mk" uniqKey="Kim M">MK Kim</name></author><author><name sortKey="Jo, H" uniqKey="Jo H">H Jo</name></author><author><name sortKey="Kong, Hj" uniqKey="Kong H">HJ Kong</name></author><author><name sortKey="Kim, Hc" uniqKey="Kim H">HC Kim</name></author><author><name sortKey="Kim, Jw" uniqKey="Kim J">JW Kim</name></author><author><name sortKey="Kim, Ym" uniqKey="Kim Y">YM Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, Hj" uniqKey="Lee H">HJ Lee</name></author><author><name sortKey="Han, S" uniqKey="Han S">S Han</name></author><author><name sortKey="Kim, Ys" uniqKey="Kim Y">YS Kim</name></author><author><name sortKey="Nam, Jh" uniqKey="Nam J">JH Nam</name></author><author><name sortKey="Kim, Hj" uniqKey="Kim H">HJ Kim</name></author><author><name sortKey="Kim, Jw" uniqKey="Kim J">JW Kim</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li></country></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Kwon, Jeanny" sort="Kwon, Jeanny" uniqKey="Kwon J" first="Jeanny" last="Kwon">Jeanny Kwon</name></noRegion><name sortKey="Eom, Keun Yong" sort="Eom, Keun Yong" uniqKey="Eom K" first="Keun-Yong" last="Eom">Keun-Yong Eom</name><name sortKey="Kim, In Ah" sort="Kim, In Ah" uniqKey="Kim I" first="In Ah" last="Kim">In Ah Kim</name><name sortKey="Kim, Jae Sung" sort="Kim, Jae Sung" uniqKey="Kim J" first="Jae-Sung" last="Kim">Jae-Sung Kim</name><name sortKey="Kim, Kidong" sort="Kim, Kidong" uniqKey="Kim K" first="Kidong" last="Kim">Kidong Kim</name><name sortKey="Kim, Young Beom" sort="Kim, Young Beom" uniqKey="Kim Y" first="Young-Beom" last="Kim">Young-Beom Kim</name><name sortKey="No, Jae Hong" sort="No, Jae Hong" uniqKey="No J" first="Jae Hong" last="No">Jae Hong No</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a LymphedemaV1
| This area was generated with Dilib version V0.6.31. |  |